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TSH DÜZEYİ NORMAL, DÜŞÜK VE YÜKSEK HASTALARDA VÜCUT KİTLE İNDEKSLERİNE GÖRE HDL DÜZEYLERİNİN KARŞILAŞTIRILMASI

Year 2022, Volume: 29 Issue: 1, 93 - 99, 01.03.2022
https://doi.org/10.17343/sdutfd.1000885

Abstract

Amaç
Obezite dünyada prevelansı gittikçe artan bir sağlık
problemidir. Obezite ayrıca dislipideminin önemli nedenlerinden
biridir Son yıllarda tiroid hormon düzeyleri
ve vücut kitle indekslerini (VKİ) karşılaştıran pek
çok çalışma vardır. Ayrıca tiroid hormon testleri ve
lipid profilini inceleyen çalışmalarda mevcuttur. Bu
çalışmanın amacı, erişkin bireylerde Tiroid Stimulan
Hormon (TSH) düzeyleri normal, düşük ya da yüksek
olmasının vücut kitle indeksine göre Yüksek Dansiteli
Lipoprotein (HDL) düzeylerine etkisinin değerlendirilmesidir.
Gereç ve Yöntem
Çalışma retrospektif olarak veri analiz yöntemiyle dizayn
edildi. Aralık 2016- Eylül 2020 tarihleri arasında
özel bir üniversite hastanesinin Checkup polikliniğine
başvurmuş; Herhangi bir tiroid ilacı kullanmayan,
TSH, VKİ, HDL değerleri bakılmış, 18 yaş üstü bireylerin
verileri toplandı(n=1621). Sosyo-demografik veri
olarak ayrıca her hasta için yaş ve cinsiyet verileri
de kaydedildi. Veriler SPSS 25.0 paket programıyla
analiz edildi. Sürekli değişkenler ortalama ± standart
sapma ve ortanca (min, maks), kategorik değişkenler
ise sayı ve yüzde olarak ifade edildi. Verilerin normal
dağılıma uygunluğu Kolmogorov Smirnov testi ve
histogramlar ile incelendi. Bağımsız grup incelemelerinde;
Mann Whitney U testi ve Kruskal Wallis Varyans
Analizi (post hoc: Bonferroni düzeltmeli Mann
Whitney U testi) kullanıldı. Kategorik değişkenler arasındaki
farklılıkların incelenmesinde ise Ki kare testi
kullanıldı. Tüm analizlerde p<0,05 istatistiksel olarak
anlamlı kabul edildi.
Bulgular
Normal kilolu olan kişilerde TSH sınıflarına göre HDL
değerleri istatistiksel olarak anlamlı farklılık gösterdi.
TSH değeri 0.5 ve 4 mİU/mL arasında olan kişilerin
HDL değerleri TSH değeri 4 mİU/mL ve üzerinde olan
kişilere göre anlamlı şekilde düşük bulundu (p=0,005).
Obez kişilerde ise TSH durumlarına göre HDL durumlarına
bakıldığında istatistiksel olarak anlamlı farklılık
olmadığı görüldü (p>0,05).
Sonuç
Çalışmamızda normal kilolu olan kişiler arasında TSH
değeri normal olanların HDL değerleri, TSH değeri
yüksek olanlara göre anlamlı şekilde düşük bulundu.
Bu konuda hem erişkin hem çocuklarda yapılan bazı
çalışmalar olsa da hala araştırmaya açık bir konudur.
Bu alanda yapılacak yeni çalışmalar ile konu hakkında
daha ayrıntılı ilişkiler saptanabilecektir.

Supporting Institution

Yok

Project Number

Yok

References

  • Obesity and overweight. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Erişim tarihi: 23.09.2021
  • OECD Health Statistics 2014. Available at: https://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequently-requested-data. Erişim tarihi: 23.09.2021
  • İslamoğlu Y, Koplay M, Sunay S ve ark. Obezite ve Metabolik Sendrom. Tıp Araştırmaları Dergisi. 2008; 6: 3.
  • Carantoni M, Vigna GB, Stucci N, et al. Low Levels of HDL Cholesterol in Hypothyroid Patients With Cardiovascular Diseases. Minerva Endocrinol. 1997; 22(4): 91-7.
  • Reinehr T, Andler W, Denzer C, et al. Cardiovascular Risk Factors in Overweight German Children and Adolescents: Relation to Gender, Age and Degree of Overweight. Nutrition, Metabolism and Cardiovascular Diseases. 2005; 15(3): 181-187.
  • Burke V, Beilin LJ, Simmer K, et al. Predictors of Body Mass İndex And Associations With Cardiovascular Risk Factors in Australian Children: A Prospective Cohort Study. İnternational Journal of Obesity. 2005; 29(1): 15-23.
  • Ekinci F, Coşkun DM, Tuncel B ve ark. Relationship Between Obesity and Thyroid Function in Adults. Marmara Medical Journal. 2018; 31: 76-80.
  • Buscemi S, Verga S, Maneri R, et al. İnfluences of Obesity and Weight Loss on Thyroid Hormones. A 3–3.5- Year Follow- Up Study on Obese Subjects With Surgical Bilio-Pancreatic Bypass. J Endocrinol İnvest. 1997; 20: 276-81.
  • Manji N, Boelaert K, Sheppard MC, et al. Lack of Association Between Serum TSH or Free T4 and Body Mass İndex in Euthyroid Subjects. Clin Endocrinol. 2006; 64: 125-8.
  • Altunoğlu E, Ülgen E, Müderrisoğlu C ve ark. Obezite ve Tiroid Fonksiyonları. İstanbul Tıp Dergisi. 2009; 1: 24-5.
  • Shinkov A, Borissova AM, Kovatcheva R, et al. The Prevalence of the Metabolic Syndrome İncreases Through The Quartiles of Thyroid Stimulating Hormone in A Population-Based Sample of Euthyroid Subjects. Arq Bras Endocrinol Metabol. 2014; 58: 926-32.
  • Lagrost L. Regulation of Cholesteryl Ester Transfer Protein (CETP) Activity: Review of invitro and invivo Studies. Biochim Biophys Acta. 1994; 1215:209–36.
  • Pearce EN, Wilson WF, Yang Q, et al. Thyroid Function and Lipid Subparticle Sizes in Patients With Short-Term Hypothyroidism and a Population-Based Cohort. J Clin Endocrinol Metab, 2008; 93: 888–94.
  • Lam KS, Chan MK, Yeung RT. High-density Lipoprotein Cholesterol, Hepatic Lipase and Lipoprotein Lipase Activities in Thyroid Dysfunction-Effects of Treatment. QJ Med. 1986; 59: 513–21.
  • Dullaart RP, Hoogenberg K, Groener JE, et al. The Activity of Cholesteryl Ester Transfer Protein is Decreased in Hypothyroidism: A Possible Contribution to Alterations in High-Density Lipoproteins. Eur J Clin İnvest. 1990; 20: 581-7.
  • Duntas LH. Thyroid Disease and Lipids. Thyroid Journal. 2002; 12(4): 287-93.
  • Asvold BO, Vatten LJ,Nilsen IL, et al; The Association Between TSH Within the Reference Range and Serum Lipid Concentrations in a Population-Based Study. The HUNT Study. Eur J Endocrinol. 2007; 156: 181–6.
  • Kung AW, Pang RW, Lauder I, et al. Changes in Serum Lipoprotein(a) and Lipids During Treatment of Hyperthyroidism. Clin Chem. 1995; 41: 226–31.
  • Aviram M, Luboshitzky R, Brook JG. Lipid and Lipoprotein Pattern in Thyroid Dysfunction and the Effect of Therapy. Clin Biochem. 1982; 15: 62–6.

COMPARISON OF HDL LEVELS ACCORDING TO BODY MASS INDEXES IN PATIENTS WITH NORMAL, LOW AND HIGH TSH LEVELS

Year 2022, Volume: 29 Issue: 1, 93 - 99, 01.03.2022
https://doi.org/10.17343/sdutfd.1000885

Abstract

Objective
The prevalence of obesity is an increasing health
problem throughout the world. Obesity is also one of
the major causes of dyslipidemia. There have been
many studies comparing thyroid hormone levels and
body mass indexes (BMI) in recent years. There are
also studies available in thyroid hormone tests and
studies examining lipid profile. The aim of this study
is to evaluate the effect of normal, low or high Thyroid
Stimulated Hormone (TSH) levels on High Density
Lipoprotein (HDL) levels according to body mass
index in adult individuals.
Material and Methods
The study was retrospectively designed with data
analysis method. The study was applied in the private
university hospital Checkup clinic between December
2016 and September 2020; TSH, VKİ, HDL values
were studied, and data of individuals over 18 years of
age were collected (n=1621). As sociodemographic
data, age and gender data were also recorded for each
patient. Data was analyzed via SPSS 25.0 package
program. Continuous variables are expressed as
mean ± standard deviation and median (min, max),
and categorical variables are expressed as numbers
and percentages. Kolmogorov Smirnov Smirnov test
and histograms was used to examine compliance
of data to normal distribution. In independent group
reviews Mann Whitney U test and Kruskal Wallis
Variance Analysis (post hoc: Mann Whitney U test with
Bonferroni correction) were used. In the examination
of the differences between categorical variables, the
Ki square test was used. All analysis P<0.05 was
accepted as statistically significant.
Results
HDL values differed statistically significantly in people
who were normal weight compared to TSH classes.
HDL values of people with TSH values between 0.5
and 4 mlU/mL were found to be significantly lower
than those with a TSH value of 4 mlU/mL or higher
(p=0.005). In obese people, it was observed that there
was no statistically significant difference considering
their HDL status according to TSH status (p>0.05).
Conclusion
In our study, HDL values of normal people with
normal TSH value were found to be significantly
lower than those with high TSH values among people
who were normal weight. Although there are some
studies in both adults and children, it is still open to
research. It would be possible to detect more detailed
relationships on the subject with new studies to be
carried out in this field.

Project Number

Yok

References

  • Obesity and overweight. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Erişim tarihi: 23.09.2021
  • OECD Health Statistics 2014. Available at: https://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequently-requested-data. Erişim tarihi: 23.09.2021
  • İslamoğlu Y, Koplay M, Sunay S ve ark. Obezite ve Metabolik Sendrom. Tıp Araştırmaları Dergisi. 2008; 6: 3.
  • Carantoni M, Vigna GB, Stucci N, et al. Low Levels of HDL Cholesterol in Hypothyroid Patients With Cardiovascular Diseases. Minerva Endocrinol. 1997; 22(4): 91-7.
  • Reinehr T, Andler W, Denzer C, et al. Cardiovascular Risk Factors in Overweight German Children and Adolescents: Relation to Gender, Age and Degree of Overweight. Nutrition, Metabolism and Cardiovascular Diseases. 2005; 15(3): 181-187.
  • Burke V, Beilin LJ, Simmer K, et al. Predictors of Body Mass İndex And Associations With Cardiovascular Risk Factors in Australian Children: A Prospective Cohort Study. İnternational Journal of Obesity. 2005; 29(1): 15-23.
  • Ekinci F, Coşkun DM, Tuncel B ve ark. Relationship Between Obesity and Thyroid Function in Adults. Marmara Medical Journal. 2018; 31: 76-80.
  • Buscemi S, Verga S, Maneri R, et al. İnfluences of Obesity and Weight Loss on Thyroid Hormones. A 3–3.5- Year Follow- Up Study on Obese Subjects With Surgical Bilio-Pancreatic Bypass. J Endocrinol İnvest. 1997; 20: 276-81.
  • Manji N, Boelaert K, Sheppard MC, et al. Lack of Association Between Serum TSH or Free T4 and Body Mass İndex in Euthyroid Subjects. Clin Endocrinol. 2006; 64: 125-8.
  • Altunoğlu E, Ülgen E, Müderrisoğlu C ve ark. Obezite ve Tiroid Fonksiyonları. İstanbul Tıp Dergisi. 2009; 1: 24-5.
  • Shinkov A, Borissova AM, Kovatcheva R, et al. The Prevalence of the Metabolic Syndrome İncreases Through The Quartiles of Thyroid Stimulating Hormone in A Population-Based Sample of Euthyroid Subjects. Arq Bras Endocrinol Metabol. 2014; 58: 926-32.
  • Lagrost L. Regulation of Cholesteryl Ester Transfer Protein (CETP) Activity: Review of invitro and invivo Studies. Biochim Biophys Acta. 1994; 1215:209–36.
  • Pearce EN, Wilson WF, Yang Q, et al. Thyroid Function and Lipid Subparticle Sizes in Patients With Short-Term Hypothyroidism and a Population-Based Cohort. J Clin Endocrinol Metab, 2008; 93: 888–94.
  • Lam KS, Chan MK, Yeung RT. High-density Lipoprotein Cholesterol, Hepatic Lipase and Lipoprotein Lipase Activities in Thyroid Dysfunction-Effects of Treatment. QJ Med. 1986; 59: 513–21.
  • Dullaart RP, Hoogenberg K, Groener JE, et al. The Activity of Cholesteryl Ester Transfer Protein is Decreased in Hypothyroidism: A Possible Contribution to Alterations in High-Density Lipoproteins. Eur J Clin İnvest. 1990; 20: 581-7.
  • Duntas LH. Thyroid Disease and Lipids. Thyroid Journal. 2002; 12(4): 287-93.
  • Asvold BO, Vatten LJ,Nilsen IL, et al; The Association Between TSH Within the Reference Range and Serum Lipid Concentrations in a Population-Based Study. The HUNT Study. Eur J Endocrinol. 2007; 156: 181–6.
  • Kung AW, Pang RW, Lauder I, et al. Changes in Serum Lipoprotein(a) and Lipids During Treatment of Hyperthyroidism. Clin Chem. 1995; 41: 226–31.
  • Aviram M, Luboshitzky R, Brook JG. Lipid and Lipoprotein Pattern in Thyroid Dysfunction and the Effect of Therapy. Clin Biochem. 1982; 15: 62–6.
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Ferda Kaya Zaman 0000-0002-2898-8669

Project Number Yok
Publication Date March 1, 2022
Submission Date September 26, 2021
Acceptance Date November 23, 2021
Published in Issue Year 2022 Volume: 29 Issue: 1

Cite

Vancouver Kaya Zaman F. TSH DÜZEYİ NORMAL, DÜŞÜK VE YÜKSEK HASTALARDA VÜCUT KİTLE İNDEKSLERİNE GÖRE HDL DÜZEYLERİNİN KARŞILAŞTIRILMASI. Med J SDU. 2022;29(1):93-9.

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